Age related hearing loss and conversation: before and after hearing aid fitting

Abstract

People with presbyacusis commonly report difficulties in conversation in everyday settings. Although previous research has focused on self-report inventories concerning conversation difficulties in age related hearing difficulties, there is a lack of published work describing the interactions between people with presbyacusis and their conversational partners. The aim of this study is to describe conversational interactions between people with presbyacusis and their main everyday conversational partner and to determine whether there is evidence of change in interaction before and after the fitting of hearing aids. Ten participants recruited from a larger cohort were included in this study, consisting of 5 participants with diagnosed presbyacusis and 5 frequent conversation partners. A battery of audiological assessments was completed for each participant with presbyacusis. Each participant with presbyacusis was videotaped in conversation at home with their main everyday conversational partner: once before hearing aid fitting and once two months following hearing aid fitting. The conversational interactions before and after hearing aid fitting were analysed using Conversation Analysis. The results of the study revealed that both the people with presbyacusis and the conversation partners used patterns of interaction in instances of mishearings in conversation. The person with presbyacusis shifted gaze direction to show a need for repair. In addition, the conversation partner used physical prompting to gain gaze directed attention from the person with presbyacusis. The person with presbyacusis also made verbal requests for a repair as a result of mishearings. These patterns in interaction showed co-ordination and timing of the repair recognition, initiation and completion by both parties. The phenomena uncovered in this study indicate that the responsibility to monitor and maintain conversation was increasingly placed on the conversation partner of the person with presbyacusis. This could explain why people with presbyacusis and their conversation partners frequently complain of frustration in conversation activities. In the postamplification conversations, no mishearings occurred, suggesting a trend towards fewer mishearings on conversation as a result of amplification of hearing. The research findings contribute to the evidence base concerning the real benefit of digital hearing aids to these elderly clients. The findings of this study can be used to design assessment and intervention tools in the future.